| NPI | 1790038081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP012258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012258) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP032862) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2025-06-25 |