| NPI | 1497773600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP008973) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN528536L) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP008973) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-06-08 |