| NPI | 1659664894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R190436) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 615389) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2021-09-19 |