| NPI | 1336133917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R222718) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP001583H) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2017-03-13 |