| NPI | 1801296157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014030) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN659013) |
| Enumeration Date | 2014-08-23 |
| Last Update Date | 2015-05-16 |