| NPI | 1114736832 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP032064) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA NPPA066896) | 
| Enumeration Date | 2025-01-07 | 
| Last Update Date | 2025-03-31 |