| NPI | 1588954952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340588) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP010499) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP013326) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2021-01-16 |