| NPI | 1962917500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348630) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720662) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-06-16 |