| NPI | 1750014619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025701) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN710925) |
| 363L00000X Nurse Practitioner (Licence: VA 0024189270) | |
| 363L00000X Nurse Practitioner (Licence: NY 357355) | |
| 163W00000X Registered Nurse (Licence: NY 996706) | |
| 163W00000X Registered Nurse (Licence: VA 0001275861) | |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2025-10-31 |