| NPI | 1508221045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015921) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN675276) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2020-07-21 |