| NPI | 1366722910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP011566) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN217316L) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2019-12-10 |