| NPI | 1740525146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 337491) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 337491) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2023-07-07 |