| NPI | 1295165041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F1013558) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2022-01-12 |