| NPI | 1972116309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11023500) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346528) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2024-09-17 |