| NPI | 1720682065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R206408) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN680938) |
| 363L00000X Nurse Practitioner (Licence: PA SP022994) | |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2024-04-24 |