| NPI | 1013640580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP026189) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310757-01) |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2024-11-01 |