| NPI | 1588258529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F353110) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626129) |
| 163W00000X Registered Nurse (Licence: KS 105992) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79418-032) | |
| Enumeration Date | 2021-02-20 |
| Last Update Date | 2024-07-19 |