| NPI | 1720304967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010330) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 335613) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2012-06-20 |