| NPI | 1326366246 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP015065) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN273637) | 
| Enumeration Date | 2010-05-17 | 
| Last Update Date | 2017-05-11 |