| NPI | 1881135143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP019409) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019409) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F340984-1) | |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2020-04-07 |