| NPI | 1003641671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030548) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP030548) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2025-02-18 |