| NPI | 1205494135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 2018077032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 641891) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |