| NPI | 1588930739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA041036) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA033948) |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2021-06-25 |