| NPI | 1063074243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28178115A) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2020-08-20 |