| NPI | 1619343597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013719) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA sp013719) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-17 |