| NPI | 1902158553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344331) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 745270) |
| Enumeration Date | 2012-10-06 |
| Last Update Date | 2019-10-01 |