| NPI | 1770856759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SPO26635) |
| Additional Taxonomies | 163WL0100X Registered Nurse Lactation Consultant (Licence: PA RN529339L) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2022-11-18 |