| NPI | 1356464564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18758) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 18758) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F332318) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-03-02 |