| NPI | 1205319852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019227) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SPO19227) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2022-08-09 |