| NPI | 1891355442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 344928) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 765923) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-08-22 |