| NPI | 1649816125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 2019052381) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-06-16 |