| NPI | 1194948265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007558) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F330138) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2015-05-01 |