| NPI | 1962967497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 343079) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 343079) |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2021-01-06 |