| NPI | 1740216761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R077059) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD R077259) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2016-05-13 |