| NPI | 1649622853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33340803) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-09-23 |