| NPI | 1114356656 |
|---|---|
| Other Name | NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013117) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SPO13117) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2020-08-21 |