| NPI | 1588217772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 350130) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 26905) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN287314) | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2024-07-29 |