| NPI | 1790883981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R207891) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R67130) |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-01505) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2278597) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-05-15 |