| NPI | 1124436506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338738-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R220990) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN187857) | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2021-08-17 |