| NPI | 1053799635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R218181) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP014985) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R218181) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP014985) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2021-08-04 |