| NPI | 1992078141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R125856) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC001006) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2013-04-01 |