| NPI | 1457400897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA UP004407C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: PA RN232062L) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2011-08-30 |