| NPI | 1558914648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 8473) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 689838) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 344942) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-08-18 |