| NPI | 1669957155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP021083) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LP-0000277) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2019-12-10 |