| NPI | 1578980504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009074) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F338602-1) |
| 207Q00000X Family Medicine (Licence: NC 5009074) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2021-04-02 |