| NPI | 1790135770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008544) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR18309100) |
| 163W00000X Registered Nurse (Licence: NY 701868-1) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341661) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2022-08-01 |