| NPI | 1245456623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R150399) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172564) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2017-01-06 |