| NPI | 1962912717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MD R232674) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: DC RN1050180) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NY F308467-1) | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2020-03-30 |