| NPI | 1629705843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350039) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 350039) |
| Enumeration Date | 2022-08-07 |
| Last Update Date | 2023-07-22 |