| NPI | 1891254769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020162) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN684562) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-12-17 |