| NPI | 1124582598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020096) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA 2018085716) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-01-13 |