| NPI | 1104309319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN328111L) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2021-03-04 |