| NPI | 1669453734 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024090521)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001090521)  | 
| 247100000X Radiologic Technologist (Licence: VA 0122000219)  | |
| Enumeration Date | 2005-11-07 | 
| Last Update Date | 2025-07-31 |