| NPI | 1750049706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030714) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 12441775-3102) |
| 163W00000X Registered Nurse (Licence: PA RN650054) | |
| 363L00000X Nurse Practitioner (Licence: UT 12441775-4405) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 12441775-4405) | |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2024-12-09 |