| NPI | 1700161379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 8094) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2021-03-16 |