| NPI | 1609638121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R252096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R252096) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-09-18 |