| NPI | 1376964148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R229782) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 208644) |
| Enumeration Date | 2013-12-21 |
| Last Update Date | 2019-06-19 |