| NPI | 1104416478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA 688621) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP022886) |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2024-04-19 |