| NPI | 1619507597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 310246) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 779645) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2021-07-09 |