| NPI | 1861865263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347026) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 684444) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2021-01-06 |