| NPI | 1003567371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022057) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP022057) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP022057) | |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |