| NPI | 1063812741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338826) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F338826) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2021-12-30 |