| NPI | 1740524768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337663) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 18258) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2024-05-31 |