| NPI | 1215629043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 723595-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F34737201) |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-11-14 |