| NPI | 1508892647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R095563) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017016496) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-06-16 |