| NPI | 1669016903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004889) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 8617) | |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2023-09-06 |