| NPI | 1750029062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310750) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 310750) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2025-04-10 |