| NPI | 1760152912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NY F310381-01) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: NY 310381) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NJ F310381-01) | |
| Enumeration Date | 2021-09-19 |
| Last Update Date | 2022-01-19 |