| NPI | 1669700258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010442) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN528074L) |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2012-10-31 |