| NPI | 1184981300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R204804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024175405) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2023-03-27 |