| NPI | 1710712666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 622856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 622856) |
| Enumeration Date | 2024-09-02 |
| Last Update Date | 2024-10-20 |