| NPI | 1639654122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP027758) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 9316711) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2023-12-11 |