| NPI | 1639583966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343836) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA rn212186) |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2021-01-19 |