| NPI | 1861625675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN555354) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2020-12-30 |