| NPI | 1861931313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD 182791) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC 1015127) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2017-02-16 |