| NPI | 1891754388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA UP006510B) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F333333-1) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2021-03-05 |