| NPI | 1942283247 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9338186) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F332926) | 
| Enumeration Date | 2005-11-22 | 
| Last Update Date | 2012-12-11 |