| NPI | 1487353967 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP029764) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 120129) | 
| Enumeration Date | 2023-02-23 | 
| Last Update Date | 2024-07-16 |