| NPI | 1780165159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP019366) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA 20188482) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2025-08-07 |