| NPI | 1740664341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R220716) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R220716) |
| 163W00000X Registered Nurse (Licence: NY 686422-1) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2017-02-02 |