| NPI | 1629444088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339829) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2019-09-17 |