| NPI | 1023296019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R100449) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010284) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2013-01-07 |