| NPI | 1104461912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347448) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 545356) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2024-03-04 |