| NPI | 1457417768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP009551) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 85187-2) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2018-05-01 |