| NPI | 1205263787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R226619) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN340624L) |
| 163W00000X Registered Nurse (Licence: MD R226619) | |
| 363L00000X Nurse Practitioner (Licence: PA SP013139) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2017-11-16 |