| NPI | 1225549769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 108550) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2021-03-09 |