| NPI | 1861753691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R194555) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD RN1009188) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-08-10 |