| NPI | 1164010062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344108) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 583663) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-11-12 |