| NPI | 1619494846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 7603) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0001094) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2019-09-26 |