| NPI | 1760464846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010131) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: NY F332069) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F3320691) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2022-09-30 |