| NPI | 1285200212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347707) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 347707) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-07-07 |