| NPI | 1205170206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R158722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003221) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2019-12-15 |