| NPI | 1235160854 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP009301) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 48825) | 
| Enumeration Date | 2006-07-05 | 
| Last Update Date | 2024-11-09 |