| NPI | 1386051688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 017741) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 017741) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 017741) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2020-10-29 |