| NPI | 1164134607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP026796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027348) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2023-08-22 |