| NPI | 1386814648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 3812) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1012232) |
| 363L00000X Nurse Practitioner (Licence: MD R183397) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2012-01-18 |