| NPI | 1962153817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352941) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 725044) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2023-11-17 |