| NPI | 1710360755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340292) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686906-1) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2021-09-29 |