| NPI | 1588260582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY AG07200135) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 309813) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2023-07-22 |