| NPI | 1902253420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP016295) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN656025) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2020-11-06 |