| NPI | 1942719042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R196796) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R196796) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2018-05-18 |