| NPI | 1821737321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349636) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 349636) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2023-07-17 |