| NPI | 1407378383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346158) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017667) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2021-05-27 |