| NPI | 1639489032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R165785) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1008161) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2022-07-21 |