| NPI | 1629113683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342227) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 11964) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-03-31 |