| NPI | 1730406133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006499) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012001) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F336105) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-03-24 |