| NPI | 1053989152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348047) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 650026) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-08-09 |