| NPI | 1568021590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344569) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 493615) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-20 |