| NPI | 1053783977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP015481) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015481) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2021-09-22 |