| NPI | 1811282114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 128237 - 5005139) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F336752-1) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2015-12-31 |