| NPI | 1417618679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11017641) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F348542-01) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2024-05-14 |