| NPI | 1710974852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP012069) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 301065-1) |
| 163W00000X Registered Nurse (Licence: PA RN635076) | |
| 163W00000X Registered Nurse (Licence: NY 414889) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2012-04-23 |