| NPI | 1811947039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R163844) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI 1102) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-04-03 |