| NPI | 1285623124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA TP000590A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA TP000590A) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2009-01-27 |