| NPI | 1881765113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP010045) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN091275) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2017-03-28 |