| NPI | 1326518192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 5011267) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F344170) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5011267) | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2021-03-22 |