| NPI | 1417202672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R163059) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F332078) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-13 |