| NPI | 1902379142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022379) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00883900) |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2022-03-07 |