| NPI | 1558539965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA sp007597) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA RN346981L) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2013-12-04 |