| NPI | 1700021789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP007258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP023203) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2021-02-19 |