| NPI | 1770084998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R148689) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R148659) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-06-18 |