| NPI | 1598371130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346620) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 611615) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-10-30 |