| NPI | 1518025626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017662) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R095036) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 19767) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 19767) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2019-01-22 |