| NPI | 1881188639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 343086) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 703972) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 343086) | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2020-12-16 |