| NPI | 1457174948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 354337) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F354337-01) |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-12-17 |