| NPI | 1356854988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018063) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024177797) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2024-01-09 |