| NPI | 1790062420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002990) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R180431) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2022-09-23 |