| NPI | 1215551122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R176108) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1012447) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2021-03-10 |