| NPI | 1396971198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 719031) |
| 363L00000X Nurse Practitioner (Licence: NC 5004727) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2020-11-19 |