| NPI | 1497159263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024177487) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2364523) |
| 363L00000X Nurse Practitioner (Licence: NY 344924) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP025846) | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2025-08-22 |