| NPI | 1659736247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340199) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2020-01-28 |