| NPI | 1376679290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R096840) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN52647) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-08-11 |