| NPI | 1124710496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 733791) |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-06-26 |