| NPI | 1215943774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010376) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 093006189N1) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-01-20 |