| NPI | 1861808172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9316934) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F340631-1) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-12-10 |