| NPI | 1356320543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP009037) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ AP2693) |
| 363LF0000X Nurse Practitioner Family (Licence: NY F3362551) | |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2016-07-24 |