| NPI | 1588936793 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4751) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337080) | 
| Enumeration Date | 2012-02-02 | 
| Last Update Date | 2024-06-05 |