| NPI | 1952841231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017226) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN639810) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP017226) | |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2021-01-07 |