| NPI | 1710653639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP028374) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 29989) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 29989) | |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2024-11-07 |