| NPI | 1649059551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP032951) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11028767) |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2025-08-04 |