| NPI | 1073052312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP017041) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN592600) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |