| NPI | 1578990461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 27412) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 342004) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F06172203) | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2025-08-21 |