| NPI | 1942679055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP015545) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015545) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA F0915787) | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2022-01-06 |