| NPI | 1275067134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341201-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 606771-1) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-07-21 |