| NPI | 1700883576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP008392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN521487L) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-02-04 |