| NPI | 1124583653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA RN527439L) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA Sp020082) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-03-06 |