| NPI | 1700507563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024191471) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP036054) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11018072) | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2026-06-03 |