| NPI | 1013007640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5655094-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 296721) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-04-22 |