| NPI | 1134779127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024872) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA sp024872) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0994972-NP) | |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2022-03-21 |