| NPI | 1457680191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2544842) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 335208) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2018-04-26 |