| NPI | 1104161140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 339605) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA 2269724) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2024-04-23 |