| NPI | 1639177421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP-005931-B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN-186720-1) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2007-07-08 |