| NPI | 1902901481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP000662B) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP000662B) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |