| NPI | 1639585797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24187) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 339327) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2021-04-08 |