| NPI | 1124761911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 815093) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2023-05-05 |