| NPI | 1629473764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN632871) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2019-03-14 |