| NPI | 1518062892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R205379) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT RN014969) |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 976) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-05-01 |