| NPI | 1790352276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 347751) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 779795) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 347751) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2025-07-01 |