| NPI | 1487613956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP005155B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 419058-1) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-08-02 |