| NPI | 1053300889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA UP001963B) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN198555L) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2012-06-11 |