| NPI | 1962584318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP005457-B) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA RN1350942L) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-05-03 |