| NPI | 1962697482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 348092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA VP001855B) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-01-31 |