| NPI | 1053964031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344764) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 344764) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2023-05-18 |