| NPI | 1568897726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014026) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338295) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172536) | |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2021-10-14 |