| NPI | 1033765409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020634) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN563467) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP020634) | |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2021-08-12 |