| NPI | 1912799735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024193233) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001245842) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |