| NPI | 1033172259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP001499D) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN243897L) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-07-30 |