| NPI | 1174298814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL 11018438) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 348114) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2022-04-19 |