| NPI | 1093542789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028801) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA 2023063691) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2025-11-26 |