| NPI | 1114912227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP005116C) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP005454B) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-07-08 |