| NPI | 1912678061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349618-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 705899) |
| 363L00000X Nurse Practitioner (Licence: NY F349618-01) | |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2022-10-28 |