| NPI | 1629439690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010331) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340343) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2019-05-01 |