| NPI | 1770040511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: DC RN1020063) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R221579) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2021-05-18 |