| NPI | 1619162989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R159447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD Cert. #F0807016) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2021-06-01 |