| NPI | 1720675630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F345961-01) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 639988-01) |
| Enumeration Date | 2020-12-26 |
| Last Update Date | 2021-05-10 |