| NPI | 1659784650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP13803) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R241771) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2019-12-30 |