| NPI | 1063820280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R192288) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R192288) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 5805) | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2021-08-17 |