| NPI | 1184934960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN626943) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP011551) |
| 363L00000X Nurse Practitioner (Licence: PA 014280) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2013-07-18 |