| NPI | 1245210178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1089912) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2019-07-31 |