| NPI | 1720346869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010379) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 609756) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 337302) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2021-10-13 |