| NPI | 1114240165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA RN554357) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE1002532) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2010-03-04 |