| NPI | 1568876720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33338678) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013908) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-05-15 |