| NPI | 1750042479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 20407) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2023-07-17 |