| NPI | 1790284594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018672) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN605353) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2020-08-30 |