| NPI | 1215595350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: DC RN966809) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R176249) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |