| NPI | 1396028502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP004519C) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP004520V) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2015-05-28 |