| NPI | 1215456504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F346932) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY P07794) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2021-05-18 |