| NPI | 1598213548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345407) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009458) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 7918) | |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2020-12-10 |