| NPI | 1124294558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 003778) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP010354) |
| 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00261300) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2012-04-09 |