| NPI | 1578194114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP021476) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN616161) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |