| NPI | 1720703978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F349756) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 654806) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |