| NPI | 1003990409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA UP 006104-B) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: PA UP006104B) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-03-13 |