| NPI | 1356956064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346903) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3018633) | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2023-07-19 |