| NPI | 1750750758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339753) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 604782) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2021-03-19 |