| NPI | 1770360380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP028270) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN695924) |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-20 |