| NPI | 1992784979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200980) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 200980) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-11-07 |