| NPI | 1558800870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017084) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN653066) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2020-11-19 |