| NPI | 1710446620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020156) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA038583) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-12-02 |