| NPI | 1982945507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012619) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 647725-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 340792) | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2022-10-05 |