| NPI | 1104016948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R157782) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R157782) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2020-11-11 |