| NPI | 1679282115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352886) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 515898) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2024-03-13 |