| NPI | 1164860136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021124) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 226501) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-01-05 |