| NPI | 1619869963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024194509) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001240565) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC SMAI-2DXWV) | |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-09-02 |