| NPI | 1538444369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R181762) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 67042) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2019-10-18 |