| NPI | 1700024429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010201) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN515329L) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-24 |