| NPI | 1912380239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341623) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009460) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2017-03-16 |