| NPI | 1003452533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348228) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 551329) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 348228) | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2022-01-27 |