| NPI | 1659193183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083S0010X Preventive Medicine, Sports Medicine (Licence: VA 0024191600) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024191600) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2026-07-21 |