| NPI | 1639199102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA050005) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01230900) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP025458) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 025431-23-03) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 20244) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-04-15 |