| NPI | 1205352762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5015573) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA 20529) |
| 363LF0000X Nurse Practitioner Family (Licence: NY F342160-1) | |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2022-01-12 |