| NPI | 1770831349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336895-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 336895) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2023-07-07 |