| NPI | 1356018634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348209) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 733188) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 348209) | |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-09-23 |