| NPI | 1740665611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340331)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687556)  | 
| Enumeration Date | 2015-07-21 | 
| Last Update Date | 2022-11-01 |