| NPI | 1811205941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN582101) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |