| NPI | 1245010073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP028324) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP028324) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2025-07-03 |