| NPI | 1780138750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016434) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN640091) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |