| NPI | 1578654547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL PA 2612) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL PA2612) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2009-02-27 |