| NPI | 1942321575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 2981) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9304575) |
| 363L00000X Nurse Practitioner (Licence: SC 2981) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9304575) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 342892) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2018-05-10 |