| NPI | 1194716357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA UP006009B) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA UP004356C) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2008-02-12 |