| NPI | 1477171031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25311) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 667702) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 345918) | |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2022-11-02 |