| NPI | 1124732656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027601) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN688900) |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2025-08-31 |