| NPI | 1629572870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018711) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP018711) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2021-08-27 |