| NPI | 1174085427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021933) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11001930) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2021-01-16 |