| NPI | 1386873461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341329-1) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7039) | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN176347) | |
| Enumeration Date | 2009-07-09 | 
| Last Update Date | 2021-07-08 |