| NPI | 1104369909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340464) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 7516) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2019-02-08 |