| NPI | 1194275073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016448) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN575123) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2017-11-21 |