| NPI | 1588642961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP008535) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 001343) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2007-07-09 |