| NPI | 1194477976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 348568) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 348568-01) |
| Enumeration Date | 2022-01-22 |
| Last Update Date | 2022-08-31 |