| NPI | 1366790644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R154872) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC 1024731) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2013-12-03 |