| NPI | 1538836150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345970) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 649544) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2022-03-22 |