| NPI | 1144993478 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348219)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 648053-01)  | 
| Enumeration Date | 2021-08-02 | 
| Last Update Date | 2021-10-04 |