| NPI | 1164806121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339844) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 645580) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2023-01-11 |