| NPI | 1417358375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95011169) |
| 363L00000X Nurse Practitioner (Licence: CT 6128) | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2022-06-13 |