| NPI | 1649382086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016024) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 499695) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20212) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-11-29 |