| NPI | 1427399765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R234382) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD R234382) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9269487) | |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2019-03-22 |