| NPI | 1609545631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP024361) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN656493) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP024361) | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2024-05-20 |