| NPI | 1053802504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347397) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A119636) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F347397-01) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2023-04-13 |