| NPI | 1013297753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R203820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IA F0711288) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2014-07-25 |