| NPI | 1720224637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 129331-6101) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305011) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 335818) | |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2010-05-27 |