| NPI | 1093555740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 354207) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 858630) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 354207) | |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-05-30 |