| NPI | 1205158508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F336127) |
| Enumeration Date | 2010-02-28 |
| Last Update Date | 2022-03-23 |