| NPI | 1477763936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD NP135056) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R135056) |
| 363L00000X Nurse Practitioner (Licence: MD R135036) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-04-17 |