| NPI | 1770197568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346896) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 800683) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2021-01-05 |