| NPI | 1013493105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018978) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN626441) |
| 363L00000X Nurse Practitioner (Licence: PA NPPA034189) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2022-04-26 |