| NPI | 1174192660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 347711) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 347711) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-10-28 |