| NPI | 1740786169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F345594-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 689297-1) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2020-07-08 |