| NPI | 1417432196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343628-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343628) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2021-11-08 |