| NPI | 1629603998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346111) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 542003-1) |
| Enumeration Date | 2020-03-07 |
| Last Update Date | 2020-08-13 |