| NPI | 1356572721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010799) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 14269) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2011-12-01 |