| NPI | 1245764489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347493) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687389) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 687389) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2021-08-11 |