| NPI | 1225432420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 338905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 338905) |
| 208D00000X General Practice (Licence: NY 338905) | |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2022-02-21 |