| NPI | 1083227276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022530) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN733041) |
| 163W00000X Registered Nurse (Licence: MA RN2313512) | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2023-08-14 |