| NPI | 1508868829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP010305) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MD R124819) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2010-05-20 |