| NPI | 1225646854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 346095) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F346095-01) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-01-19 |