| NPI | 1275936114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014126) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL SP014126) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2015-01-07 |