| NPI | 1992290787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008255) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343012) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-06-01 |