| NPI | 1790335966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R215034) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MD R215034) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2021-12-13 |