| NPI | 1578947651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339119) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN206253) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |