| NPI | 1982256855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP020098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN634680) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-10-02 |