| NPI | 1659816098 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: DC RN1043975)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95015539)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000022093)  | |
| Enumeration Date | 2016-12-20 | 
| Last Update Date | 2025-04-24 |