| NPI | 1184030124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339353) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 830213) |
| 163W00000X Registered Nurse (Licence: NY 668144) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP95002308) | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2021-03-09 |