| NPI | 1770159659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 432027) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 432027) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-07-07 |