| NPI | 1760814081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN562089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013812) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2025-07-26 |