| NPI | 1558786129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8808) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338563) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2019-03-26 |