| NPI | 1992337851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R208199) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN653777) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP021564) | |
| Enumeration Date | 2020-02-09 |
| Last Update Date | 2024-01-12 |