| NPI | 1568862977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014690) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA RN568383) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2018-08-14 |