| NPI | 1972268076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F348665) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 582995) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2022-02-18 |