| NPI | 1023661188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: NY 405257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F344519) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2023-12-06 |