| NPI | 1851034987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP025109) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN659816) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP025109) | |
| Enumeration Date | 2022-04-17 |
| Last Update Date | 2022-09-26 |