| NPI | 1578163911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R248169) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM RN-75836) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD MJ6513813) | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-08-20 |