| NPI | 1053691857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP011568) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN568877) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2020-12-30 |