| NPI | 1285163345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 341597) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 635098) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341597) | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |