| NPI | 1548980915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350769) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 350769) |
| 163W00000X Registered Nurse (Licence: NY 752121) | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-10-10 |