| NPI | 1962114686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP027175) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11033140) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2025-02-11 |