| NPI | 1831653310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007593) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F343693) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2024-12-03 |