| NPI | 1396435442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 345747) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 345747) |
| 208000000X Pediatrics (Licence: NY 345747) | |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-05-11 |