| NPI | 1790295608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018322) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA F09171561) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-04-12 |