| NPI | 1477149250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 342467) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 342467) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-05-17 |