| NPI | 1154078376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350748) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2357319) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2022-12-12 |