| NPI | 1497315659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344900) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-03-07 |