| NPI | 1801411475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021925) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN656392) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP021925) | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |