| NPI | 1962561647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL NP1896212) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL NP1896212) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-10-22 |