| NPI | 1073983771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022846)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN626706)  | 
| Enumeration Date | 2015-10-07 | 
| Last Update Date | 2023-02-14 |