| NPI | 1043647340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R124929) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363LF0000X Nurse Practitioner, Family (Licence: DC RN58440) | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2024-01-03 |