| NPI | 1235447376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP011854) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA sp010968) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA sp011854) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2020-12-18 |