| NPI | 1609362623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011912) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343257) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2019-08-09 |