| NPI | 1508311150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R143946) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R143946) |
| 163W00000X Registered Nurse (Licence: PA RN669051) | |
| 163W00000X Registered Nurse (Licence: DC RN1038448) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-10-13 |