| NPI | 1972599488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012110) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F331012) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2024-05-06 |