| NPI | 1972974699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9262113) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F340031) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2019-03-07 |