| NPI | 1194766022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R105025) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R105025) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R105025) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2007-07-08 |