| NPI | 1669036836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R168616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD F04190184) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-03-14 |