| NPI | 1043223894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA rn207783L) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA vp004430C) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA vp004430C) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |