| NPI | 1417352030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN578510) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F338960) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |