| NPI | 1407563729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP027006) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN697983) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-02-15 |