| NPI | 1053781138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP015478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA RN632842) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP015478) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2022-01-07 |