| NPI | 1609281096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19320) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338808) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-05-11 |