| NPI | 1578614269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9367097) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 331180) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-07-15 |