| NPI | 1720384043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R192485) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD R192485) |
| 163W00000X Registered Nurse (Licence: MD R192485) | |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2021-11-24 |