| NPI | 1568883932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DC RN1032692) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024171354) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NY 306540) | |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2018-01-08 |