| NPI | 1912583717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024183866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001189803) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2024-07-30 |