| NPI | 1578979761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338782-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172839) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2015-08-06 |