| NPI | 1962458653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP006953C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA RN332145L) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-02-24 |