| NPI | 1780335521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 349065) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2024-03-06 |