| NPI | 1487378303 |
|---|---|
| Former Name | MARINA THERESA BEACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349719-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 753688-01) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2024-01-22 |