| NPI | 1689858912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 334022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP001892B) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2023-02-21 |