| NPI | 1134779853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R245734) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6929) |
| Enumeration Date | 2019-09-14 |
| Last Update Date | 2024-01-11 |