| NPI | 1881636314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R049381) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R049381) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R049381) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2010-06-09 |