| NPI | 1710390026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD r218185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA f1113277) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2015-09-01 |