| NPI | 1124623368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 431798) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 431708) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2023-05-26 |