| NPI | 1962680850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012457) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R203644) |
| 363L00000X Nurse Practitioner (Licence: VA 0024167802) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2025-03-26 |