| NPI | 1134634538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R179754) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD F11170058) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2022-09-14 |