| NPI | 1396213708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R169694) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MD 169694) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2019-01-15 |