| NPI | 1336187293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP006425B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN312584L) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2019-03-22 |