| NPI | 1902146624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS F0113390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS R879122) |
| Enumeration Date | 2013-02-15 |
| Last Update Date | 2018-11-12 |