| NPI | 1982603619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP000893C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP000893C) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2021-09-01 |