| NPI | 1104360825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R204594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1011865) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |