| NPI | 1790025724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9228616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337478-1) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-05-02 |