| NPI | 1154369700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R855212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS R855212) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA R855212) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2014-04-10 |