| NPI | 1730164450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA TP-003409-B) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN167340) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-07-13 |