| NPI | 1679154033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 654787) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 343453) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2021-04-17 |