| NPI | 1053432179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R172554) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165220) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2011-10-25 |