| NPI | 1487200267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP023800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 104124) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2023-01-11 |