| NPI | 1124165170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP006152B) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN283456L) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-10-03 |