| NPI | 1194371344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R201184) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024187037) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2024-09-09 |