| NPI | 1073995064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027291) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 339854) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2023-05-25 |