| NPI | 1770250607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347822) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 347822) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2025-06-17 |