| NPI | 1194159855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11029496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 669540) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F348058) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2024-02-11 |