| NPI | 1205495470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R204557) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R204557) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-25 |