| NPI | 1962160242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348555) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 348555) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2023-07-17 |