| NPI | 1548597131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MD R185483) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001221655) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024168544) | |
| 363LF0000X Nurse Practitioner Family (Licence: TX 827537) | |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2016-04-19 |