| NPI | 1700393816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018339) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12169) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704434081) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN10016175) | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2025-10-08 |