| NPI | 1619470747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP019086) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP018689) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2025-08-27 |