| NPI | 1558855296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348747) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010974) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 348747) | |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2022-03-14 |