| NPI | 1619573425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346630) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10175) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2021-12-05 |