| NPI | 1730158288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP003877B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F331424-1) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2008-03-27 |