| NPI | 1366960403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 308157) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: NY 684259) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2021-08-10 |