| NPI | 1649522756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337390) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 238335) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2019-10-18 |