| NPI | 1659467157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9172104) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F3330731) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2009-06-24 |