| NPI | 1578815478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP005862B) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN235168L) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2021-04-16 |