| NPI | 1902459951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020628) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA F07191012) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2022-08-16 |