| NPI | 1083053011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008173) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00427500) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP012834) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2016-03-03 |