| NPI | 1124692462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 348640) |
| Additional Taxonomies | 163WX0003X Registered Nurse Obstetric, Inpatient (Licence: NY 641036) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-10-14 |