| NPI | 1962826255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013663) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN207834L) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-10 |