| NPI | 1730064288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024193880) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024193880) |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-08-06 |