| NPI | 1124608641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 641750) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310061) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2023-05-01 |