NPI | 1235617465 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP019015) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP019015) |
Enumeration Date | 2018-07-31 |
Last Update Date | 2018-10-24 |