| NPI | 1942939467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310755-01) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 310755) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2023-07-22 |