| NPI | 1790857779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 337268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337268) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-04-09 |