| NPI | 1255097309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F350023-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 0967572) |
| 363L00000X Nurse Practitioner (Licence: NY 350023) | |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2023-07-22 |