| NPI | 1952936528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23789) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 410906) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5019063) | |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2023-11-30 |