Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | VP004737P | PA |
NPI | 1003979634 |
---|---|
Provider Name | Mrs. Kathleen Leflar Dileva |
First Address | Collegeville, PA 19426-2868 |
Second Address | Lafayette Hill, PA 19444-1813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |