| NPI | 1184209009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347420) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 733782) |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2021-03-11 |