| NPI | 1033393665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 172138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 561779) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F335348) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5007534) | |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2022-01-27 |