| NPI | 1104364686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341370-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 611605) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2021-05-12 |