| NPI | 1700429131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 345127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F345127-01) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2021-01-17 |