| NPI | 1720529290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339931-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F3399311) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2023-03-08 |