| NPI | 1649779166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R211788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175852) |
| Enumeration Date | 2018-02-10 |
| Last Update Date | 2018-02-10 |