| NPI | 1356696876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP012455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN610906) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2013-03-20 |