| NPI | 1912725821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP030949) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN520412L) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-12-02 |