| NPI | 1497730436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R164969) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD R164969) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9401308) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2021-08-31 |