| NPI | 1629646427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347806) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 718071) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 347806) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-07-07 |