| NPI | 1730732082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005680) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344673) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2020-04-13 |