| NPI | 1003563495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025448) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F359783-01) |
| 363L00000X Nurse Practitioner (Licence: FL 11048224) | |
| 363L00000X Nurse Practitioner (Licence: PA SP025448) | |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2026-07-01 |