| NPI | 1285156752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 2016028291) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 349465) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11001479) | |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2023-08-22 |