| NPI | 1063062834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: HI 2769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 345210) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2020-07-31 |