| NPI | 1255972071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027931) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 162109) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2024-05-06 |