| NPI | 1275098717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016460) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11016460) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NY F342784-1) | |
| Enumeration Date | 2019-02-08 | 
| Last Update Date | 2024-03-22 |