| NPI | 1073956157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA Sp016378)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP016378)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: MD R205596)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP016378)  | |
| Enumeration Date | 2013-04-09 | 
| Last Update Date | 2022-08-23 |