| NPI | 1700922572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC001038FNP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R138110) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 17737RNAPRNFNP) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-07-12 |