| NPI | 1861893034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014168) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN587897) |
| 363L00000X Nurse Practitioner (Licence: PA SP014168) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2021-01-23 |