| NPI | 1033796602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 347556) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 674065) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 347556) | |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2025-03-18 |