| NPI | 1740559632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343624) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 644943) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2024-09-09 |