| NPI | 1376312264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NY F421563-01) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: NY 656781-01) |
| Enumeration Date | 2023-12-20 |
| Last Update Date | 2023-12-20 |