| NPI | 1730420969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 337898) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 337898) |
| 363LF0000X Nurse Practitioner Family (Licence: MA 283908) | |
| 363LF0000X Nurse Practitioner Family (Licence: DC 1034940) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2019-03-13 |