| NPI | 1104499854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 351287) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 735763) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2023-03-30 |