| NPI | 1154987543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344465) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 553555) |
| Enumeration Date | 2019-05-12 |
| Last Update Date | 2022-02-28 |