| NPI | 1134608755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010924) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2021-05-04 |