| NPI | 1063113751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP027285) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP027285) |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2025-10-30 |