| NPI | 1659633287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP011915) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5014) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP011915) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2018-07-03 |