| NPI | 1023065679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R122160) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD TRU104262354) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2013-05-09 |