| NPI | 1184098089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018801) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018801) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN252571) | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2022-05-13 |