| NPI | 1700686128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP032670) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA 2024074114) |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-05-08 |