| NPI | 1790305415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F345850) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004481) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-08-21 |