| NPI | 1972068716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 353529) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN263300) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2024-02-02 |