| NPI | 1508133927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R068465) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MD ANCC-0021755) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |