| NPI | 1760762322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015899) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1008964) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R174342) | |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2021-08-18 |