| NPI | 1780980201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R218153) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336619) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2021-02-15 |