| NPI | 1619911674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R067563) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R067563) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R067563) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-06-11 |