| NPI | 1992040463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP012625) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN556173) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2022-07-21 |