| NPI | 1265146062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F350973-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 534881) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-08-29 |