| NPI | 1962107623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027401) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN684828) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-07 |