| NPI | 1194819466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP006381B) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN505820L) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-06-22 |