| NPI | 1275208886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP024111) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN702792) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP024111) | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-10-05 |