| NPI | 1053729616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 22360) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F306952-1) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-08-11 |