| NPI | 1740894492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP022687) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA F09200601) |
| 163W00000X Registered Nurse (Licence: PA RN653698) | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-11-11 |