| NPI | 1962067116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F354726) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 758038) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2024-08-09 |