| NPI | 1609397884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R224972) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R224972) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F341377-1) | |
| 163W00000X Registered Nurse (Licence: NY 675313-1) | |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-11-22 |