| NPI | 1508865031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003320) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F301557) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F333997) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2020-02-11 |