| NPI | 1528723608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F346672) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 346672) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2023-07-17 |