| NPI | 1639669120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018812) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP0000X) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2019-08-28 |