| NPI | 1528042579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM R41491) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NM R41491) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2016-05-04 |