| NPI | 1083011944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY f339073-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001359) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2017-05-06 |