| NPI | 1154480374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R171107) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R171107) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R171107) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2013-04-24 |