| NPI | 1710402243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F343685-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024175083) |
| Enumeration Date | 2017-08-05 |
| Last Update Date | 2019-01-22 |