| NPI | 1245990605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA NPPA058751) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN549799) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP025511) | |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2024-05-08 |