| NPI | 1235792466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 854907) |
| 163W00000X Registered Nurse (Licence: NY 780616) | |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2019-12-10 |