| NPI | 1972505295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD r130790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD r130790) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2009-02-13 |