| NPI | 1114539269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP025407) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 346354) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2023-11-13 |