| NPI | 1255109146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 728084) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F354812-01) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-12-09 |