| NPI | 1255955100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 309927) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 691426-01) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2021-05-11 |