| NPI | 1639522691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25205) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F331811-1) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2022-06-24 |