| NPI | 1528394632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 14985) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00253500) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2014-05-12 |