| NPI | 1861891566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MD R198504) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN294528) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: DC RN1014424) | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2021-06-09 |