| NPI | 1861895955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD AC002004) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP013644) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MD AC002004) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2018-07-31 |