| NPI | 1174109508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347484) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F347484-01) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-04-28 |