| NPI | 1619486966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA F09171519) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2021-01-07 |