| NPI | 1790917912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F336598) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2017-03-31 |