| NPI | 1568745123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SPO11612) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN547445) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |