| NPI | 1902369044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 764192) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 11826) | |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2025-01-29 |