| NPI | 1578257069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019189) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F352037) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2024-01-04 |