| NPI | 1417363458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014016) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN575045) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2020-12-12 |