| NPI | 1619247053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9439800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336947) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2017-04-01 |