| NPI | 1407689870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030310) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11034854) |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2025-07-22 |