| NPI | 1548748106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP019062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 9782) |
| Enumeration Date | 2018-08-04 |
| Last Update Date | 2023-06-23 |