| NPI | 1811329766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN614739) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA RN614739) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2015-05-07 |