| NPI | 1184698532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP004279C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA VP004279-C) |
| 363L00000X Nurse Practitioner (Licence: NY F301832-1) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2021-04-07 |