| NPI | 1124080502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014158) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00082000) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP008569) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2023-03-01 |