| NPI | 1093866618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA VP003308C) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA RN312707L) | 
| Enumeration Date | 2007-01-12 | 
| Last Update Date | 2023-03-07 |