| NPI | 1275149106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F309861-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 604515) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |