| NPI | 1356983688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP020852) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2020-06-11 |