| NPI | 1003499500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347432-01) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 584658-01) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |