| NPI | 1881231967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309358) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 309358) |
| Enumeration Date | 2019-12-08 |
| Last Update Date | 2024-08-05 |