| NPI | 1639462591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 17574) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F336742-1) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2022-01-20 |