| NPI | 1669245874 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188631) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024188631) | 
| Enumeration Date | 2023-10-31 | 
| Last Update Date | 2025-07-09 |