| NPI | 1992165054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10121583-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687210) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 9426325) | |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2020-09-30 |