| NPI | 1689237794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP026397) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 102689) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-11-17 |