| NPI | 1942799341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 343221) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 647261) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2019-01-07 |