| NPI | 1104504018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352494) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 750485) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-24 |