| NPI | 1134245251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R150861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024160921) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-05-22 |