| NPI | 1104595990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 310494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 621603) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2023-11-29 |