| NPI | 1588372817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 349722) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 734375) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 349722) | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-07-22 |