| NPI | 1518749464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F352205-01) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: NY F352205-01) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-11-13 |