| NPI | 1841185543 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024194681) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001331344) |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-09-16 |