| NPI | 1922613249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP022564) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN-523463L) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-11-11 |