| NPI | 1336453604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010937) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN228939L) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2010-08-26 |