| NPI | 1669827911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 221693) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 558990) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F340103) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2022-03-24 |