| NPI | 1790459485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F07210044) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F350320) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2022-10-11 |