| NPI | 1376519900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA TP006735B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F333092-1) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2021-02-26 |