| NPI | 1174677694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R071879) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R071879) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-10-26 |