| NPI | 1366092264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350303) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002751) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2024-07-11 |