| NPI | 1992176143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP015587) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP015587) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2016-07-13 |