| NPI | 1659816098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: DC RN1043975) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: TN APN0000022093) |
| 363L00000X Nurse Practitioner (Licence: CA 95015539) | |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2021-07-28 |