| NPI | 1730456005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022179) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 651536) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 337056) | |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2021-02-01 |