| NPI | 1962100669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10009557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F350501-01) |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 203286) | |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2024-12-17 |