| NPI | 1376805713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R165749) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP030931) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2024-12-11 |