| NPI | 1942401211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 334517) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 179026) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2014-07-02 |