| NPI | 1649553116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011688) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN585787) |
| 363L00000X Nurse Practitioner (Licence: PA SP011688) | |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2020-12-19 |