| NPI | 1487632063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP007580) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5000686) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 0050-00686) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2025-03-17 |