| NPI | 1154751204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD R194701) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DC RN102501) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2022-09-21 |