| NPI | 1619610581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025600) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: PA SP025600) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2023-03-21 |