| NPI | 1679070916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F348548) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 746738) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2022-03-28 |