| NPI | 1508835059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ TAP8519) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP006559B) |
| 363L00000X Nurse Practitioner (Licence: NY F331840-1) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2016-03-15 |