| NPI | 1417422056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F343880-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9347623) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2023-03-16 |