| NPI | 1407817133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP004767M) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN254020L) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2023-05-08 |