| NPI | 1043636301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP013260) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB-0000290) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2015-12-13 |