| NPI | 1568833770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP015477) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN340160L) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2018-04-30 |