| NPI | 1104477504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 344739) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F34473901) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2023-04-10 |