| NPI | 1023370921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R135462) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012115) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R135462) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2023-01-03 |