| NPI | 1275603847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP005538C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN315927L) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2011-11-18 |