| NPI | 1790758696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP006306C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP006306C) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2021-08-02 |