| NPI | 1164701207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 696281) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2024-07-25 |