| NPI | 1053954602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1005511) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R176420) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2021-10-18 |