| NPI | 1902973456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB 0000267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017269) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R194665) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-10-22 |