| NPI | 1588277875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346011-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 615402-1) |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2021-07-02 |