| NPI | 1912550153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020464) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN627013) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP020464) | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2020-04-16 |