| NPI | 1508697855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP031175) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11034516) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-03-20 |