| NPI | 1306030176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R185505) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9167751) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2010-01-22 |