| NPI | 1215415294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 280363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343211) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2019-07-12 |