| NPI | 1891234951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 342701) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 716579) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 342701) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 7593) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2024-01-02 |