| NPI | 1255802286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP019817) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN520884L) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-02-20 |