| NPI | 1639941685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 352366) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 352366) |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2024-05-10 |