| NPI | 1396846978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN251489L) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA VP004015P) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |