| NPI | 1194499376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP024027) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP024027) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-09-10 |