| NPI | 1740132794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP035404) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA RN763393) |
| Enumeration Date | 2026-02-12 |
| Last Update Date | 2026-03-23 |