| NPI | 1740761253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA NPPA062415) |
| Additional Taxonomies | 183700000X Pharmacy Technician |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2024-07-23 |