| NPI | 1780114736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 5428634) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 729679) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 353419) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2024-07-13 |