| NPI | 1508825969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP003151C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F301060-1) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-07-29 |