| NPI | 1104589159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP042773760001) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP022833) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-06-25 |