| NPI | 1952852790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP016866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN637840) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-12-06 |