| NPI | 1508574013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F350025-01) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-05-14 |