| NPI | 1750613931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010717) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN530437L) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |