| NPI | 1467564898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 300652) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-09-17 |