| NPI | 1417653601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 355141) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 798247) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2024-10-08 |