| NPI | 1861768699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R200346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001227118) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2016-08-17 |