| NPI | 1154874220 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R099071) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024173630) | 
| Enumeration Date | 2016-07-25 | 
| Last Update Date | 2020-06-15 |