| NPI | 1538557582 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019228)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2290563)  | 
| Enumeration Date | 2014-12-29 | 
| Last Update Date | 2018-11-09 |