| NPI | 1376957613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349559-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 173215-7) |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2024-01-19 |