| NPI | 1184061053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R097837) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012765) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2016-05-19 |