| NPI | 1720638745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345020) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F34502001) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-09-12 |