| NPI | 1861754830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R170058) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA TLRN038422) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2018-03-17 |