| NPI | 1700101862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP023623) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024187212) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75106-122) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2023-06-21 |