| NPI | 1528646320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP023275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN580934) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP023275) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2022-06-03 |