| NPI | 1952700197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24529) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005755) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 5755) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F338949-1) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2022-03-11 |