| NPI | 1811993082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR A01317) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R874973) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2014-03-21 |