| NPI | 1780447003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024194301) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001262152) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2026-01-13 |