| NPI | 1245983683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP024808) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA 662134) |
| 163W00000X Registered Nurse (Licence: NJ 26NR21394400) | |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-05-14 |