| NPI | 1023632064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP025489) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R195870) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-04-26 |