| NPI | 1093113045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA VP004217C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: PA RN296185L) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |