| NPI | 1952821118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 340707) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: NY 340707) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-05-21 |