| NPI | 1376082354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R147422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 107458) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2020-09-18 |