| NPI | 1164538542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA TP004241C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NR09033800) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: PA TP004241C) | |
| 363LX0106X Nurse Practitioner Occupational Health (Licence: NJ 26NR09033800) | |
| 363LX0106X Nurse Practitioner Occupational Health (Licence: PA TP004241C) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |