| NPI | 1942972625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP022644) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022644) |
| 363L00000X Nurse Practitioner (Licence: PA SP022644) | |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2025-01-14 |